Oral Presentation Palliative Care Nurses Australia Conference 2020

Making Palliative Care everyone’s business in residential aged care: a local improvement approach to strengthen practice in residential aged care facilities (RACFs) (70191)

Kathleen Menzies 1
  1. North and West Metropolitan Region Palliative Care Consortium, Fitzroy North, VICTORIA, Australia


In September 2017, funding was received to improve afterhours access to palliative care for RACF residents in north-western Melbourne. 


  • To strengthen RACF staff and GP skills, knowledge, capacity and confidence to provide palliative care
  • To examine RACF use of external support services for residents requiring palliative care
  • To increase referrals from RACFs to community/specialist palliative care services.


Eight RACFs comprising ‘for profit’, ‘not for profit’ and ‘public sector’ providers were invited to review their palliative care systems and practices, identify strengths and weaknesses and design and implement targeted and meaningful improvement Initiatives. 

Executive Sponsors’ of participating RACFs embraced the initiative and promoted palliative care and end of life care as core business.   Working groups with representation from management, GPs and staff were established to support engagement; ensure improvements were contextually correct and owned by internal stakeholders; and lay the foundation for sustainable improvement.

Working groups controlled the scope and pace of improvement processes and focused on strengthening systems; knowledge and practice relating to advance care planning; identification of deterioration; symptom management and end of life care; referral indications and pathways to support services. 


RACF staff and GPs had access to education and training in advance care planning, symptom management and end of life care and workshops were videoed to ensure ongoing access for those unable to attend training. 

Collaboration with externals stakeholders including specialist and community palliative care services, and other participating RACFs was actively encouraged throughout the project. 

Feedback from participants and their organisations confirmed the methodology was an effective and supportive way to improve practice.

External project management was key to supporting working groups allowing them to focus on implementing and communicating improvements.

Discussion & conclusion:

Working together with key stakeholders in RACFs was an excellent way to build and consolidate capacity.

At the completion of the project each RACF established systems to collect and report palliative care practice and outcomes measures to monitor practice and trend improvements.